Clinical nutrition and metabolismClinical nutrition and metabolismКлиническое питание и метаболизм2658-44332782-2974Eco-Vector2065010.17816/clinutr20650ReviewsНаучные обзорыResearch ArticleCachexia and sarcopenia at oncological patients: diagnostics and treatment tacticsКахексия и саркопения у онкологических пациентов: диагностика и лечебная тактика4517-3380KhoroshilovI. E.ХорошиловИгорь Евгеньевич
Russian Federation

д.м.н., профессор кафедры анестезиологии и реаниматологии

ighor1@yandex.ruNorth-Western State Medical University named after I.I. MechnikovФГБОУ ВО «Северо-Западный государственный медицинский университет имени И.И. Мечникова» Минздрава России230420201136461702202023032020Copyright ©; 2020, Khoroshilov I.E.Copyright ©; 2020, Хорошилов И.Е.2020Khoroshilov I.E.Хорошилов И.Е.https://creativecommons.org/licenses/by/4.0https://journals.eco-vector.com/2658-4433/article/view/20650

Background. The features of malnutrition are revealed at 30–85% of oncological patients.

Aims. To represent present knowledges on causes and mechanisms of development, clinical features and treatment of cachexia and sarcopenia at oncological patients, including nutritional support and target pharmacotherapy.

Discussion. Cancer cachexia it is necessary to install in case of weight loss on 10% and more from initial and body mass index in adults less than 17 kg/m2. To diagnose of sarcopenia and cachexia are used the bioelectrical impedance analysis, computer and the magnetic resonances tomography. To be treated and warning of sarcopenia and cachexia is used the nutritional support. The enteral nutrition is appointed, when the energy intakes with nutrition less than 60% from required during 1–2 weeks, or in the presence of sarcopenia or cachexia. Beyond that, the oncological patients are to get the target pharmacotherapy. For maintaining of muscle mass by the oncological of a patients it is recommended physical activity, exercise, this refers and to palliative patients.

Conclusion. Cachexia and sarcopenia are characteristic of most of the oncological patients. The development of these conditions can cause substantial increase of different complicating diseases and lethality. To prevent their may be in due time designated personalized nutritional support, including additional enteral nutrition and target pharmacometabolic therapy.

Обоснование. Признаки недостаточного питания выявляются у 30–85% онкологических пациентов.

Цель — представить современные данные о причинах и механизмах развития, клинических признаках и лечении кахексии и саркопении онкологических пациентов, включая нутриционную поддержку и направленную фармакотерапию.

Обсуждение. Кахексию у онкологических больных следует устанавливать при снижении массы тела на 10% и более от исходной и индексе массы тела у взрослых менее 17 кг/м2. Для диагностики саркопении и кахексии используют биоимпедансный анализ, компьютерную и магнитно-резонансную томографии. Для лечения и предупреждения саркопении и кахексии используется нутриционная поддержка. Энтеральное питание назначается, когда энергоценность пищи составляет менее 60% необходимого объема в течение 1–2 нед, либо при наличии саркопении или кахексии. Кроме того, онкологические пациенты должны получать таргетную фармакотерапию. Для поддержания мышечной массы онкологическим больным рекомендованы двигательная активность, физические упражнения, это же относится и к паллиативным больным.

Заключение. Кахексия и саркопения характерны для большинства онкологических пациентов. Развитие этих состояний может приводить к существенному росту различных осложнений и летальности. Предупредить их может своевременно назначенная персональная нутриционная поддержка, включающая дополнительное энтеральное питание и направленную фармако-метаболическую терапию.

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